What is Ischemia
What is Ischemia

What is Ischemia?

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What is Ischemia?

What is Ischemia? Ischemia is the inadequacy of blood supply to the tissues or organs of the body. Ischemia arises from the presence of problems in the blood vessels. Ischemia can also be interpreted as a local anemia that generally occurs in certain areas of the body, such as the heart, intestines, brain, and extremities (hands and feet).

This condition causes the tissue or organs to deficiency of nutrients and oxygen needed for the process of cell metabolism while keeping it alive. If not treated properly, cell death may occur.

Causes of Ischemia

Ischemia is caused by disruption of blood vessels that interfere with the blood supply to tissues or organs. Some conditions that can cause inadequate blood supply include:

  • Atherosclerosis, ie thickening, reduced flexibility, or hardening of blood vessel walls. This condition causes the lumen of blood vessels getting narrower.
  • Occlusion or closure of blood vessels. The clots (thrombus) occurring inside the blood vessels can escape and follow the bloodstream, then cause a blockage (embolism).
  • Trauma or injury. The suppression, shaking, or tear resulting from traumatic events may result in total or partial closure of the blood vessels.
  • Aneurysms or dilation of abnormal blood vessels that occur in blood vessel walls and are local.
  • Myocardial infarction.
  • Heart valve disease.
  • Chronic atrial fibrillation.
  • Cardiomyopathy.
  • Tachycardia.
  • Hypoglycemia.
  • Anemia.
  • Hypotension.
  • Sickle cell disease

Symptoms of Ischemia

Reduced blood supply in the metabolic process can trigger ischemia in different tissues and organs. In other words, this condition has different symptoms, such as:

  • Ischemia of the heart

Symptoms in this condition can be chest pain (angina) due to the heart muscle does not receive enough blood flow (angina pectoris). This is due to the atherosclerosis due to the buildup of cholesterol in the blood vessels of the heart. Chest pain that arises can spread to the hands, neck, chin, and back. In addition to chest pain (angina), can also occur heart attack when the heart vessel closed in total. Ischemic heart disease is also known as coronary heart disease.

  • Ischemia of the intestine

Symptoms in this condition may include abdominal pain due to inflammation of the colon (ischemia colitis) or small intestine (mesenteric ischemia). Other symptoms may include diarrhea, nausea, discharge of reddish stains and sometimes blood, and dehydration.

  • Ischemia in the brain

Symptoms of ischemia in the brain depend on the affected area. Symptoms can include dizziness, confusion, blurry vision, loss of body coordination or difficulty speaking or understanding the words of others.

  • Ischemia in the legs

Symptoms in this condition include paralysis, cramps in one area of the leg, cold, pain that does not go away on the fingers, legs, or legs, and changes in the color of the legs.

Symptoms of ischemia that is not treated immediately can also damage organs in a relatively quick time, such as the kidney organs. Low-metabolic tissue due to lack of oxygen obtained from the blood can be damaged after 20 minutes.

The destruction of tissue occurs due to accumulation of metabolic waste, triggering cells to destroy itself, to leak proteolytic enzyme autolyzing enzymes to surrounding cells and tissues. Ischemia can also trigger the development of gangrene, necrosis, and paralysis conditions so it should be recognizable symptoms.

Diagnosis of Ischemia

The doctor will ask you some questions about the symptoms you are complaining about and do a series of physical examinations to confirm the diagnosis of ischemia. Investigations for ischemic conditions depend on the affected area, such as:

  • Ischemia of the heart

The recommended investigations, such as electrocardiogram (EKG) test to determine oxygen and echocardiogram levels to determine the structure and performance of the heart. Cardiac enzyme examination may also be performed to determine the condition of the heart muscle, cardiac catheterization to determine the level of constriction and pressure on the vessels and heart chambers. Other tests are MRI and CT scan.

  • Ischemia of the intestine

Recommended investigations include blood tests to determine the number of white blood cells and lactic acid, ultrasound, X-ray, CT scan, endoscopy, colonoscopy, and MRI angiography. Endoscopy aims to determine the level of oxygen adequacy in the intestines. MRI angiography to differentiate ischemia in the colon or small and ultrasound to get a clearer bowel picture. The colonoscopy procedure is useful for obtaining a direct description of the intestinal condition to confirm the diagnosis. The doctor may also perform examinations of the patient’s stool to ascertain the infection causing the appearance of this symptom.

  • Ischemia in the brain

Recommended investigations, including blood tests to determine cholesterol and blood sugar levels, MRI, and CT scans. Echocardiography can be done to find if there is a blood clot (clot) that may come from the heart. Another test is carotid ultrasound to know the presence of blockage or constriction of the carotid artery in the neck area. Neurological examination is also done to find out what kind of response and coordination of the patient’s body.

  • Ischemia in the legs

Recommended investigations, including ultrasound, angiography, X-ray, MRA, CTA, or catheter angiography to determine the condition of blood flow and blood vessels. Ankle testing can also be done to determine the ratio of ankle systolic blood pressure to systolic arm (brachial) blood pressure, also called Ankle-Brachial Index (ABI). Doctors can take blood samples of patients to determine cholesterol levels, triglycerides, and possibly diabetes.

Treatment of Ischemia

Ischemic treatment involves administration of drugs, vascular surgery, adjustment of body condition, to the option of amputation. Of course it will be adjusted based on areas of the body that are ischemic.

Some possible treatments include:

  • Provision of anticoagulant medication. Heparin can be injected to the patient to prevent the occurrence or enlargement of blood clots in the blood vessels. This treatment can also run for long periods in cases of severe blood clots that can trigger acute ischemia.
  • Thrombolysis. This treatment can be done by injecting plasmin-producing protein to stimulate the occurrence of secondary fibrinolysis process preventing blood clotting. This procedure is performed by using a catheter mounted on the skin surface directly into the area where a blood clot is present.
  • Embolectomy. Emergency surgical procedure to remove clots of mass inside the blood vessels that inhibit blood circulation.
  • Surgical revascularization. Surgical procedure performed on blood vessels to restore organs or body parts. For example by way of making a wedge or a tear in the walls of arteries, also called arteriotomy.
  • Angiography catheter. This procedure targets the constricted blood vessels, then dilates them by dissolving drugs that will smooth the flow of blood.
  • Amputation. This action is the final treatment option for ischemia occurring in the leg area and is not possible to be treated with other procedures.

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